Incidental Pancreatic Cyst

Algorithms

ANY Incidental Pancreatic Cyst in patient >80 y/o

<1.5cm Incidental Pancreatic Cyst

1.5 - 2.5cm Incidental Panc Cyst WITH Main Duct communication

1.5 - 2.5cm Incidental Panc Cyst W/O (or indeterminate) Main Duct communication

>2.5cm Incidental Panc Cyst

"Worrisome Features"

Cyst >= 3cm long axis
Thickened/enhancing cyst wall
Nonenhancing mural nodule
Main pancreatic duct >= 7mm at thickest point

"High-Risk Stigmata"

Obstructive jaundice with cyst in head of pancreas
Enhancing solid component within cyst
Main pancreatic duct >=10mm in absence of obstruction

Growth Definition

Size <0.5cm: 100% increase in long axis diameter
>0.5 and <1.5cm: 50% increase in long axis
>1.5cm: 20% increase in long axis

Things to Report

1. Morphology and location
2. Size
3. Possible communication with MPD
4. Presence of "worrisome features" or "high-risk stigmata"
5. Growth on f/u exam
6. Multiplicity

Link to Full Article



Reference only- Previous 2010 White Paper Guidelines
Incidental Cystic Lesion